Rapid - Male/Female GU Flashcards Preview

M2 - Pharm Rapid > Rapid - Male/Female GU > Flashcards

Flashcards in Rapid - Male/Female GU Deck (57):
1

Leuprolide

  • GnRH analog
  • Use:
    • Pulsatile: infertility (puls)
    • Continuous: prostate cancer / uterine fibroids / precocious puberty
  • S/E
    • antiandrogenic
    • nausea

2

GnRH analog pulsatile delivery

  • increases FSH/LH
  • used for infertility

3

GnRH analog continuous delivery

  • suppresses FSH/LH
  • used for prostate cancer, uterine fibroids, precocious puberty

4

Ethinyl estradiol

  • Estrogen analog
  • Use:
    • hypogonadism
    • ovarian failure
    • HRT
    • androgen-dep prostate cancer
  • S/E:
    • endometrial cancer
    • postemenopausal bleeding
    • thrombi
  • C/I: ER+ breast cancer, Hx DVT

5

DES

  • Estrogen analog
  • Use:
    • hypogonadism
    • ovarian failure
    • HRT
    • androgen-dep prostate cancer
  • S/E
    • vaginal clear cell adenocarcinoma (in utero exposure)
    • endometrial cancer
    • postemenopausal bleeding
    • thrombi
  • C/I in ER+ breast cancer, Hx DVT

6

Mestranol

  • Estrogen analog
  • Use:
    • hypogonadism
    • ovarian failure
    • HRT
    • androgen-dep prostate cancer
  • S/E:
    • endometrial cancer
    • postemenopausal bleeding
    • thrombi
  • C/I in ER+ breast cancer, Hx DVT

7

Clomiphene

  • Estrogen receptor modulator
  • ANTagonist at hypothalamus
  • Partial AGonist at ovary
  • Use: Anovulatory infertility (PCOS)
  • S/E:
    • hot flashes
    • ovarian enlargement
    • multiple simultaneous pregnancies
    • visual disturbances

8

Tamoxifen

  • Estrogen receptor modulator
  • ANTagonist at breast
  • AGonist at bone, uterus
  • Use: treat & prevent recurrence of ER/PR+ breast cancer
  • S/E increased risk thromboembolism and endometrial cancer
    • use limited to 5yrs

9

Raloxifene

  • Estrogen receptor modulator
  • ANTagonist at breast, uterus
  • AGonist at bone
  • Use: osteoporosis
  • S/E: increased risk thromboembolism but NOT endometrial cancer

10

HRT

  • Estrogen + Progesterone (Unopposed estrogen increases risk of endometrial cancer, so progesterone is added)
  • Use:
    • relief or prevention of menopausal symptoms
    • osteoporosis
  • S/E: poss increased CV risk

11

Anastrozole

  • Competitive aromatase inhibitor
  • Decreases estrogen synth
  • Use: postmenopausal PR+ breast cancer
  • S/E: osteoporosis

12

Exemestane

  • Covalently binds and inhibits aromatase
  • Decreases estrogen synth
  • Use: Postmenopausal PR+ breast cancer
  • S/E: osteoporosis

13

Letrozole

  • Competitive aromatase inhibitor
  • decreases estrogen synth
  • Use: postmenopausal PR+ breast cancer
  • S/E: osteoporosis

14

Formestane

  • Covalently binds and inhibits aromatase
  • Decreases estrogen synth
  • Use: Postmenopausal PR+ breast cancer
  • S/E: osteoporosis

15

Progestins

  • Bind progesterone receptors
  • decrease endometrial prolif
  • increase endometrial vascularization
  • thicken cervial mucus
  • Use:
    • oral contraceptives
    • endometrial cancer
    • abnl uterine bleeding
  • C/I:
    • smokers > 35yo
    • Hx thromboembolism / stroke
    • Hx estrogen-dep tumor

16

Mifepristone

  • Competitive progestin inhibitor at progesterone receptors
  • Use: add to misoprostol (PGE1) for pregnancy termination
  • S/E:
    • Heavy bleeding
    • GI fx
    • abd pain

17

Estrogen + Progestins

  • Inhibit LH/FSH → prevent estrogen surge → inhibit ovulation
  • Use: oral contraception
  • C/I:
    • Smokers > 35yo
    • Hx thromboembolism / stroke
    • Hx estrogen-dep tumor

18

Levonorgestrel

  • synthetic progestin
  • blocks LH surge
  • Use: prevents ovulation after unprotected sex

19

Terbutaline

  • Beta-2 agonist
  • Use: reduce uterine contraction frequency during labor

20

Ritodrine

  • Beta-2 agonist
  • Use: reduce uterine contraction frequency during labor

21

Danazol

  • Synthetic androgen
  • Partial AGonist at androgen receptors
  • Use:
    • endometriosis
    • hereditary angioedema
  • S/E:
    • hepatotoxicity
    • decreased HDL
    • weight gain
    • edema
    • hirsutism / masculinization

22

Testosterone / methyltestosterone

  • AGonist at androgen receptors
  • Use:
    • hypogonadism
    • promotion of 2º sex char
    • anabolism stim to promote burn recovery
  • S/E:
    • gonadal atrophy
    • premature closure of epiphyseal plates
    • increased LDL + decreased HDL
    • masculinization in females

23

5α-reductase inhibitors

prevent conversion of testosterone to DHT

24

Finasteride

  • 5α-reductase inhibitor
  • Use:
    • BPH
    • male pattern baldness

25

Flutamide

  • Nonsteroidal competitive Androgen inhibitor
  • Use: prostate carcinoma

26

Ketoconazole

  • Inhibits steroid synthesis (17,20-desmolase)
  • Use: PCOS
  • S/E:
    • gynecomastia
    • amenorrhea

27

Spironolactone

  • Inhibits steroid binding, 17α-hydroxylase, and 17,20-desmolase
  • Use: PCOS
  • S/E:
    • gynecomastia
    • amenorrhea

28

Tamsulosin

  • α1A antagonist
  • inhibits smooth mm contraction in prostate
  • Use: BPH
  • Caution w/cataract Sx

29

Sildenafil

  • PDE-5 inhibitor
  • increases cGMP → smooth mm relaxation in corpus cavernosum → increased blood flow → penile erection
  • Use: ED
  • S/E:
    • cyanopsia (blue-tinted vision) → PDE-6 inhibition
    • HA, flushing, dyspepsia
  • C/I with nitrates (life-threatening hypOtension)
  • Interacts w/α1 blockers

30

Vardenafil

  • PDE-5 inhibitor
  • increases cGMP → smooth mm relaxation in corpus cavernosum → increased blood flow → penile erection
  • Use: ED
  • S/E:
    • cyanopsia (blue-tinted vision) → PDE-6 inhibition
    • HA, flushing, dyspepsia
  • C/I with nitrates (life-threatening hypOtension)
  • Interacts w/α1 blockers

31

Tadalafil

  • PDE-5 inhibitor
  • increases cGMP → smooth mm relaxation in corpus cavernosum → increased blood flow → penile erection
  • Use: ED
  • S/E:
    • back pain / mm aches → PDE-11 inhibition
    • cyanopsia (blue-tinted vision) → less often bc more selective for PDE-5
    • HA, flushing, dyspepsia
  • C/I with nitrates (life-threatening hypOtension)
  • Interacts w/α1 blockers

32

Minoxidil

  • Direct arteriolal vasodilator
  • Use:
    • androgenic alopecia
    • severe refractory HTN

33

Ganirelex

  • GnRH antagonist
  • Use: prevent premature LH surge in woman undergoing controlled ovarian hyperstim

34

Doxazosin

  • α1 antagonist
  • inhibits vascular and prostate smooth mm contraction
  • Use:
    • BPH urinary symptoms
    • HTN
  • S/E: 1st-dose orthostatic hypOtension

35

Dutasteride

  • 5α-reductase inhibitor
  • Use:
    • BPH
    • male pattern baldness

36

Terazosin

  • α1 antagonist
  • inhibits vascular and prostate smooth mm contraction
  • Use:
    • BPH urinary symptoms
    • HTN
  • S/E: 1st-dose orthostatic hypOtension

37

Prazosin

  • α1 antagonist
  • inhibits vascular and prostate smooth mm contraction
  • Use:
    • BPH urinary symptoms
    • HTN
  • S/E: 1st-dose orthostatic hypOtension

38

M3 antagonist

stops bladder contraction

39

Oxybutynin

  • M3 antagonist
  • Use:
    • reduce bladder spasms
    • urge urinary incontinence (OAB)
  • S/E: antimuscarininc

40

Tolterodine

  • M3 antagonist
  • Use:
    • Reduce bladder spasms
    • Urge urinary incontinence (OAB)
  • S/E: antimuscarininc

41

Solifenacin

  • M3 antagonist
  • Use:
    • reduce bladder spasms
    • urge urinary incontinence (OAB)
  • S/E: antimuscarininc

42

Mirabegron

  • Selective β3 agonist
  • Promotes detrusor relaxation
  • Use: OAB

43

Onabotulinumtoxin A

  • Injected into detrusor muscle during cystoscopy to block Ach release at NMJ
  • effect lasts 19-24 weeks
  • Use: OAB

44

Sildosin

  • α1A antagonist
  • inhibits smooth mm contraction in prostate
  • Use: BPH

45

Drugs that can cause urinary retention

  • Anticholinergics
  • Antidepressants
  • Antipsychotics
  • Beta-adrenergic agonists
  • Calcium channel blockers
  • Opioids

46

Drugs that can cause polyuria, frequency, urgency

  • Alcohol
  • Caffeine
  • Diuretics

47

Drugs that can cause ED

  • Beta-blockers
  • Centrally-acting anti-HTN drugs
  • Digoxin
  • Spironolactone
  • Thiazide diuretics
  • Most antidepressants
  • Typical antipsychotics
  • Anticonvulsants
  • Lithium
  • 5α-reductase inhibitors
  • Alcohol
  • Cimetidine
  • Opioids
  • Corticosteroids

48

Metformin

  • Reduces insulin resistance
  • Helps restore regular ovulatory menses and normalize testosterone levels
  • Use: PCOS

49

Cabergoline

  • DA agonist
  • Use: Prolactinoma

50

Bromocriptine

  • Ergot DA agonist
  • Use:
    • Prolactinoma
    • Neuroleptic Malignant Synd

51

Drospirenone

  • Androgen antagonist
  • Aldosterone antagonist → lower BP
  • Use: oral contraception (w/estrogen)

52

Medroxyprogesterone acetate

  • Progestin
  • Depot injection
  • Use:
    • oral contraception when estrogen C/I
    • chemical castration in males

53

Rx Allergies + BPH

Antihistamines (H1 blockers) with few antimuscarinic S/E:

  • Cetirizine
  • Fexofenadine
  • Loratadine

Avoid anything that blocks M3 (diphenhydramine) or alpha-1 (pseudoephedrine), which can worsen BPH urinary symptoms

54

Drugs that can cause Priapism

Anything with alpha-1 antagonist activity:

  • Tamsulosin
  • Tadalafil
  • Trazodone
  • Thioridazine
  • Doxazosin

55

Dinoprostone

  • PGE2
  • Induces cervical softening and effacement
  • Causes cervical dilation and uterine contractions
  • Use:
    • Ripening of cervix for induction of labor
    • 2nd trimester abortion
    • Benign hydat moles

56

Drugs that can cause tocolysis

  • Tocolysis = uterine mm relaxation
  • Produced by Beta-2 AGonists

 

57

Misoprostol

  • PGE1
  • Use:
    • w/mifepristone to induce abortion
    • labor induction
    • postpartum bleeding